Tennessee
|[pic] |Tennessee Department of Children’s Services |
| |Child Specific Recruitment Case File Review Tool (Archeological Dig) |
|Child’s Name | |Date of Custody | |Date of Full Guardianship | |
|Date | |Completed By | |
|Permanency Specialist | |FSW | |
|Date of Initial Archeological Dig Planning Meeting: | |
|Date of Follow-up Meeting to Present Archeological Dig Results: | |
|Resources Utilized: |Case File | | |
| |Interview with Child | | |
| |Social Media | | |
| |Search Engine | | |
| |Other | | |
Introduction
Purpose: An Archeological Dig is a process that utilizes various tools and strategies to conduct an intensive search to identify, locate, and engage family members, kin, and other individuals in a child or youth’s past that could potentially provide a permanent home or lifelong connection. Archeological Digs are used when a child/youth has not established legal permanency.
This tool is designed to assist the child’s worker when reviewing the child and family case record for potential permanent placement resources, individuals who could assist in identifying placement resources, or individuals who might serve as ongoing supports to the child.
In addition, the tool collects information helpful in the development of the child's Lifebook, background information for formal presentations, full disclosure forms and subsidy documents.
Therefore, a single thorough review of the child and family case records can serve to satisfy several case management responsibilities. More importantly, after a meticulous review of the case record, the members of the child’s permanency team become more knowledgeable regarding the child and are better equipped to identify a family to meet the child's lifelong needs.
Directions:
1. Obtain the child and family’s case record.
2. In an organized fashion, review each piece of paper in the case record.
3. As critical information is uncovered, record it on the appropriate section of this tool.
4. Once the case record review is completed, analyze the tool and identify potential placement resources, supports, or individuals who could be utilized as members of the recruitment team.
Child Interview
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|Child’s Placement History |
| |Dates Resided |Placement Name |Address |Telephone |
|2. | | | |( ) - |
|3. | | | |( ) - |
|4. | | | |( ) - |
|5. | | | |( ) - |
|6. | | | |( ) - |
|7. | | | |( ) - |
|8. | | | |( ) - |
|9. | | | |( ) - |
|10. | | | |( ) - |
|11. | | | |( ) - |
|12. | | | |( ) - |
|13. | | | |( ) - |
|14. | | | |( ) - |
|15. | | | |( ) - |
|16. | | | |( ) - |
|17. | | | |( ) - |
|18. | | | |( ) - |
|19. | | | |( ) - |
|20. | | | |( ) - |
|Notes: |
|Birth Mother’s Background Information |
|Name: | |aka: | |DOB: | |
|Addresses known to reside: |
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| |
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|Birth Mother’s Relatives: |
|Name |Relationship |Address |Telephone No. |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
|Other Individuals Connected to the Birth Mother: |
|Name |Relationship |Address |Telephone No. |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
|Notes: |
|Birth Father’s Background Information |
|Name: | |aka: | |DOB: | |
|Addresses known to reside: |
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| |
| |
|Birth Father’s Relatives: |
|Name |Relationship |Address |Telephone No. |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
|Other Individuals Connected to the Birth Father: |
|Name |Relationship |Address |Telephone No. |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
| | | |( ) - |
|Notes: |
|Siblings |
|Name |DOB |Relationship |Address & Telephone |
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|Notes: |
|Other Significant Contacts |
|Name |DOB |Relationship |Address & Telephone |
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|Notes: |
|School Information |
|Schools Attended: |
|Name of | | |Telephone Number |Important People to Child*|
|School |Dates Attended |Address | | |
| | | |( ) - | |
| | | |( ) - | |
| | | |( ) - | |
| | | |( ) - | |
| | | |( ) - | |
| | | |( ) - | |
| | | |( ) - | |
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|Notes: |
|Health Information |
|Current Primary Doctor |Dentist |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Specialist |Eye Doctor |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|PT/OT/Speech Therapist |Past Doctors |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Notes: |
|Mental Health Information |
|Current Therapist |Residential Treatment |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Past Therapist |Residential Treatment |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Past Therapist |Hospitalization |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Past Therapist |Hospitalization |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Dates of Service | |Dates of Service | |
|Notes: |
|Social and Community Contacts |
|Religious Affiliations |Mentor Programs |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Visiting Family |Scouts/Clubs |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Sports/Recreation |Friends |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Friends |Employer |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Notes: |
|Social Services Contacts |
|Social Worker |Past Social Worker |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Guardian Ad Litem |Court Appointed Child Advocate (CASA) |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Recruiter |Contract Agency Social Worker |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Independent Living Specialist |Other Staff* |
|Name | |Name | |
|Address | |Address | |
|City | |State | |
|Notes: |
*Other staff may include clerical, transportation, training, etc. who may have had contact with the child.
|Additional Information, Contacts or Potential Leads for the Child |
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|Placement EcoMap |(Name of Placement) |
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| |Friends | |
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|School | |Church |
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|Neighbors | |Foster Parent’s Extended Family |
| |Child's Name | |
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|Employment | |Activities |
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|Genogram for | |
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| | |Father | | |Mother | |
| | |
| | |
| |* |Father |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
|Father’s Sibling | |DOB: | |
| |Address: | |
*Blank is to indicate whether the parent is a birth parent, step parent, adoptive parent, god parent, etc.
|Genogram for | |
| | | | | |
| | | | | |
| | | | | |
| | |Father | | |Mother | |
| | |
| | |
| |* |Mother |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
|Mother’s Sibling | |DOB: | |
| |Address: | |
*Blank is to indicate whether the parent is a birth parent, step parent, adoptive parent, god parent, etc.
|Genogram for | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
|Child’s Sibling: | |Sex: | M F |DOB: | |
|Address: | |
|Currently Living With: | |
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